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HomeMy WebLinkAbout39903-Z r , ,'%11 0,Eir p Town of Southold 8/26/2015 e G ;� • P.O.Box 1179 1 53095 Main Rd cf, `dol Id 1Y Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37740 Date: 8/26/2015 THIS CERTIFIES that the building ELECTRICAL Location of Property: 325 Summit Ln, East Marion SCTM#: 473889 Sec/Block/Lot: 35.-8-5.23 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/26/2015 pursuant to which Building Permit No. 39903 dated 6/26/2015 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: 2 LED LIGHTS ON POLE IN REAR YARD The certificate is issued to Alfonso,Fernando&Alfonso, Stacey of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 39903 08-13-2015 PLUMBERS CERTIFICATION DATED Authorized Signature o t,r TOWN OF SOUTHOLD • BUILDING DEPARTMENT TOWN CLERK'S OFFICE Pyr o� SOUTHOLD, NY 01 „ Ma. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 39903 Date: 6/26/2015 Permission is hereby granted to: Alfonso, Fernando &Alfonso, Stacey 41-38 Westmoreland St Little Neck, NY 11363 To: Electric installation for pole with LED light At premises located at: 325 Summit Ln, East Marion SCTM # 473889 Sec/Block/Lot# 35.-8-5.23 Pursuant to application dated 6/26/2015 and approved by the Building Inspector. To expire on 12/25/2016. Fees: ELECTRIC $85.00 Total: $85.00 Buil;'i ig Inspector gi /���,�O��OF SOOr�ol _ Town Hall Annex �� ~ o : Telephone(631)765-1802 54375 Main Road ; * Z Fax(631)765-9502 P.O.Box 1179 % cl, ; as. 0 r` oger.richertRtown.southold:ny.us : Southold,NY 11971-0959 091, __... 0i BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Alfonso Address: 325 Summit Lane City: East Marion St: New York Zip: 11939 Building Permit#: 39903 Section: 35 Block: 8 Lot: 5.23 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Pro Electric License No: 41413-ME SITE DETAILS Office Use Only Residential Indoor Basement Service Only Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 1 Twist Lock Exit Fixtures TVSS Other Equipment. 2 LED Lights On Pole In Rear Yard Notes: ---..) Inspector Signature: V-7,--52- c-------- Date: August 13, 2015 Electrical 81 Compliance Form.xls v: 9 , I \„/ ,,,',zc s01'jy� , D• 1 all Annex I 1 +� 4 , , • 46 % Telephone(631)765-1802'07 'i Y .� ax(6.51)705- 5p2 O' .,ox P'°� 6 �_�� If " Q �� roger.richertWtaown.souni.ny.us Sou •old, ` 11971-0959 Al :'e 0-0',11 BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUEST-ED BY: �`' i I E2-rtjAiu 0 0 • 1� s o Date: G-26- ZO l S� 'Company Name: ,�r _ - 1f cevi r,•vL�a Name: • ' k‘,6 ---r@: ®.);e\1°� a - \ ci � \eect c' - ;- - License No.: t41b--NS- _ Address: \� -, -N,a(.1%pip\‘IN QoCie.e 6-tt`cenr-\ i Phone No.: Q5 \._ bo 4i oG k i JOBSITE INFORMATION: (*Indicates required information) - *Name: 325- Sv►Kp° f LA-0-Eskmbo A yLs') *Address: % 2 S U .14 f- L PrN'S - - *Cross Street: He v- - - ru � *Phone No.: -Z 18 3,44-+-log 6 • _ Permit No.: _ 2j?6?()aj Tax•Map District: - 1000 Section: 3.s Block: 8 Lot: S- 2 3 • *BRIEF DESCRIPTION OF WORK(Please Print Clearly) - . 1K4114( 4/0ri 0f PIt. L LED Grg/-/ - . I . (P(ease Circle All That Apply) • *Is job ready for inspection: - YES(Tb. Rough In Final *Do-you need a Temp Certificate: YES - - 3 Temp Information I - •. . . - . � - *Service Size: 1 Pi _- 3Phase 100 150 200 300 350 400 Other *New Service: Re-conne t Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection FormU � Pte- ,,• , 1 " ,„._ ... 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'` ai.`'- b`"a , , .1,,;,„t/'/,,7 'fz:•':_>,'tti _ ",,-0.F,k' • Su, alkCounty Executive's Office of. onsumer Affairs fc s ` r'-�= . - This is to'certify thatMARIO TASSIELLI - - ',Has duly qualified by examination and is, therefore, entitled to,receive•a" MASTE• R ELECTRICIAN •' r�-g 4 .,., • • - • ` „ license'from the;Suffolk County,Exeeutive's-Office of Consumer Affairs-in accordance with g ` the provisions of the Suffolk County Occupational Licensing Law. '• � ' , Restrictions5:.:.: ,, 044 • - s of� ,'. • 'Dated: ' : - 8/28/2006 j: a3 g$r&s:, 5. i• v • 1 ` - Te$°,�I .e p `'', , ' - yh I NOT'VALID`WITHOUT', ;�' , Y a ;, l • , ,DEPARTMENTAL SEAL f • • •�, �F . 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Y .6'','W-4 ,'OU' ,40/7,44,,,,, "'�';3 , ;('n • `C F9'''' 'TJ . 1Ti+.� t �,s, s i �;, ,sem .s 3.� u �zy�� r 1 Y` d#+ w�, q,.*,."'ry$, a� K 's,. ���'i:, Bif'"'..�, '��' •�"�. ;�,,,�, .,'ize ,y.uY.S1`+,�` :n'r`.`f�`{:r.', ,f ,�- {, �' ,'', r Cc <-r' _,.�.:��"S �•/' '4'''V4 r'T'�t e.r a. . � f,�fc.,... - . . -;s,.,. • v ,. .,> 1,, -t ... ^. e'. w;• 4,,,,,,:.....:,:v $ �d d t S ar ,. > . ' w � .w c�k .., .Ar ids` '+ � uMrn• d A CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DD/YYYY) 12/9/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE,CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Veronica Treadwell Cafarelli Insurance Agency ((AHico.No.Extt: (631)543-6363x203 (A No):(631)543 4891 1030 Jericho Turnpike E-MAIL ADDRESS: y veronical cafarellia corn ene INSURER(S)AFFORDING COVERAGE NAIC fl Smithtown NY 11787 INsuRERA:Merchants Insurance Group INSURED Pro Electric of Suffolk LLC INSURERB: 1175 Champlin Place INSURERC: Greenport, NY 11944 INSURER D: INSURER E• INSURER F: COVERAGES CERTIFICATE NUMBER:CL1412902840 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID.CLAIMS NSR ADDL SUBR LTR TYPE OF INSURANCE IN R WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMlDDlYYYY) (MMlDDIYYYY) A GENERAL LIABILITY 50P1082805 12/09/2014 12/09/2015 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea occurrence) $' 500,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG s 2,000,000 —Xi POLICY n n LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ — _ AUTOS (Per accident) UMBRELLA UAB ^ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- 0TH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED N/A E L EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Suffolk County Department of Consumer Affairs ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 6600 AUTHORIZED REP': E • Hauppauge, NY 11788 . Ar. CORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. NS025(2010os)01 The ACORD name and loco are reaisterpri markt of ACnizn